Relationships between trunk muscle activation and thoraco-lumbar kinematics in non-specific chronic low back pain subgroups during a forward bending task

Hemming, Rebecca ORCID: https://orcid.org/0000-0002-8708-5638, du Rose, Alister, Sheeran, Liba ORCID: https://orcid.org/0000-0002-1502-764X, van Deursen, Robert ORCID: https://orcid.org/0000-0002-9461-0111 and Sparkes, Valerie ORCID: https://orcid.org/0000-0003-4500-9327 2024. Relationships between trunk muscle activation and thoraco-lumbar kinematics in non-specific chronic low back pain subgroups during a forward bending task. Gait & Posture 107 , pp. 96-103. 10.1016/j.gaitpost.2023.09.018

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Abstract

Background Trunk muscle activity and thoraco-lumbar kinematics can discriminate between non-specific chronic low back pain (NSCLBP) subgroups and healthy controls. However, research commonly focuses on lumbar kinematics, with limited understanding of relationships between kinematics and muscle activity across clinical subgroups. Similarly, the thoracic spine, whilst intuitively associated with NSCLBP, has received less attention and potential relationships between spinal regions and muscle activity requires exploration. Research question Is there a relationship between trunk muscle activation and regional thoracic and lumbar kinematics in NSCLBP subgroups during a forward bending task? Methods Observational, case-control study. Fifty subgrouped NSCLBP motor control impairment participants (27 Flexion Pattern (FP-MCI), 23 Active Extension Pattern (AEP-MCI)) and 28 pain-free controls were evaluated using 3D motion analysis (Vicon™) and surface electromyography during a forward bending and return to upright task. Mean sagittal angles for the upper-thoracic (UTx), lower-thoracic (LTx), upper-lumbar (ULx) and lower-lumbar (LLx) regions were compared with normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and erector spinae (longissimus thoracis) muscles between groups. Pearson correlations were computed to assess relationships (significance p < 0.01). Results AEP-MCI individuals demonstrated statistically significant relationships between superficial lumbar multifidus and ULx and LLx kinematics (−.812 to.659). FP-MCI individuals exhibited statistically significant relationships between erector spinae and superficial lumbar multifidus and LLx and LTx kinematics (−.686 to.664) in both task phases, and between external oblique and LTx during forward bending) (−.459 to.572). Correlations were moderate to strong for all significant relationships (−.812 to .664). Significance Relationships between muscle activity and regional spinal kinematics varied between NSCLBP subgroups, suggesting that those with flexion- or extension-related LBP adopt different motor control strategies when performing a bending task. As effectively mechanical biomarkers, these findings may inform treatment by improving understanding of varied motor strategies in subgroups.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Publisher:	Elsevier
ISSN:	0966-6362
Funders:	Versus Arthritis
Date of First Compliant Deposit:	16 October 2023
Date of Acceptance:	28 September 2023
Last Modified:	31 Oct 2023 14:54
URI:	https://orca.cardiff.ac.uk/id/eprint/163216

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